Nicolas Ayer is, in many ways, a typical 3-year-old boy. He loves baseball, cars and Nickelodeon cartoons, hates taking naps and is eager to please his parents.

But when you look a little closer, some of the things that set Nico apart are apparent. He wears an orthotic brace on his right leg, favors his left side and talks less than many kids his age.

Nico suffered a stroke shortly before or after he was born and was diagnosed with cerebral palsy within 36 hours of his birth. That early diagnosis resulted in his nearly immediate entrance into a state-funded program that provides medical therapy to children with special needs. Because of that ongoing help, his parents say, he can walk, run, throw a ball and attend preschool with his peers. Without it, he might have spent his life in a wheelchair.

But the California Children's Services' Medical Therapy Program will soon be out of reach for Nico's family and thousands of other Californians if lawmakers approve a budget proposal by Gov. Jerry Brown, who is trying to close a $15.7 billion shortfall in the state's general fund.

His proposal - which has received some pushback in the Senate already - calls for eliminating the service for families that make more than $40,000 a year, or those that spend less than 20 percent of their income on medical services for their child. The change would save about $22 million a year - half for the state, and half for counties.

If approved, an estimated 4,779 children would lose the intensive physical and occupational therapy provided by the program. They are not unique: The Medical Therapy Program is just one of numerous health services, child care assistance programs and other state-funded benefits that Brown is proposing to cut. In all, tens of thousands of children would lose access to services if lawmakers approve Brown's plan.

Little choice for parents

Nico is one of them. His parents, Mike and Lisa Ayer, own a home in San Mateo; he works in online publishing, and she is a middle school teacher. They said insurance companies don't cover the long-term therapy that kids like Nico need, but they would be happy to help pay the estimated $4,595 a year the state program costs because it is the only one they know of.

But under the governor's plan, they won't even have that choice.

"That was the worst day," said Mike Ayer, recalling the moment when a neurologist showed up at his wife's hospital bedside to tell them that Nico's stroke had damaged his motor skills and speaking abilities. The doctor said Nico "might" be able to walk someday.

"But every day since then has been better," Lisa Ayer said. "He was able to walk at 22 months - that would not have happened without CCS. He took his first steps on his own there. ... It is the best medical therapy program there is."

Difficult decisions

Norman Williams, a spokesman for the Department of Health Care Services that oversees the Medical Therapy Program, said Brown's proposal is one of many "very difficult decisions" state policymakers have to make as they decide how to shave billions of dollars off state spending.

"It is unfortunate - there are many reductions in Medi-Cal that we understand have real impacts," Williams said. "But with the budget situation, we have to make difficult recommendations."

A Senate budget subcommittee rejected the cut on Thursday, saying the state should instead pay for the services with federal "special education" funds. But the fight is far from over, and it's unclear whether all the children at risk of losing their therapy would still qualify for the program if the Senate subcommittee's proposal was adopted.

'Cascading cuts'

Michele Stillwell-Parvensky, a spokeswoman for the nonprofit Children's Defense Fund of California, said Brown's proposal is just one of many "cascading cuts" that have hit children - particularly disabled kids - in recent years as federal, state and local governments withhold money from schools, health and child care budgets.

"They are incremental cuts in some ways, but when you add them all together, it's a huge hit on families that are still recovering from the economic downturn. A lot are still struggling with unemployment and are really being hit from multiple, different directions," Stillwell-Parvensky said.

She and the Ayer family worry that if the Medical Therapy Program is eliminated, the burden of trying to help these special-needs kids would fall to ill-equipped school districts - and taxpayers will end up footing the bill anyway.

"We are hoping that Nico will be independent enough to exit the (medical therapy) program ... that he will have independent life skills," Lisa Ayer said. "He has the potential to go to school, to college, to get a job and become a taxpayer. If he doesn't have life skills, he won't be independent enough to hold a job or even to sit long enough at a desk to attend school or do a desk job."